Studying the Effectiveness of Family-Focused Behavioral Therapy Interventions on Decreasing Problems of Children With the Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is one of the prevalent behavioral disorders in children that erupts in pre-school and school ages. The symptoms of this disorder negatively impact the interaction between children and parents. The ODD is a multi-factorial disorder with a complicated etiology. Its successful treatment requires comprehensive approaches and implementing the theory of mind, behavior, social cognition, and the interactions between parents and children. Behavioral parent training can effectively reduce behavioral problems and aggression in children with ODD. Therefore, using behavioral methods and behavioral management for training mothers is especially recommended. This study aimed to investigate the effectiveness of behavioral intervention centered on parents decreasing problems in children with the ODD.

The current research was compiled and implemented based on the systematic review model. Identifying and extracting articles was done using PRISMA (The Preferred Reporting Items for Systematic Reviews and Meta-Analysis) instruction. The present study's statistical population consisted of all foreign and domestic scientific research articles on the child, parent, or family-focused cognitive behavioral interventions, educational or parental behavior management, and communication interventions in children with behavioral disorders. In the first stage of the review, all related research was collected. The second stage included screening the studies, the articles were examined in terms of the topic and abstract, and the author reviewed the abstracts of the papers. In the third stage, the qualification of the studied articles was checked. The inclusion criteria were based on the methodology (research method, population, sample, and intervention) and the research that has been done as an experiment. In the fourth stage, the final papers have been determined and included in the research. For this purpose, a search was done in the internal and external databases, including PubMed, ScienceDirect, Web of Science, Google Scholar, Scopus, SID, Magiran, and Elmnet engine according to research keywords: "behavioral interventions," "cognitive-behavior therapy," "management behavior," "parent-children interaction," "externalizing disorders," "oppositional defiant disorder," "interventions centered on family, parents or mothers" in the English and Persian languages. The initial research achieved 97 articles. However, based on the systematic review study protocol and specified criteria, 17 final papers were considered for systematic review. Then, the texts of the selected articles were thoroughly reviewed, and the related information was extracted. This information included the characteristics of the research identity card, the research method (sample and kind of intervention), the intervention protocol, and the findings.

The results have shown that using cognitive-behavioral interventions, management behavior based on behavioral therapy, and parent-child interaction can improve children's behavior and decrease behavioral problems with externalizing disorder and oppositional defiant disorder. Generally, among studying articles, these results were obtained. For aggression in children with ODD, cognitive and behavioral intervention, management behavior, and parent-child interactions were effective. In addition, cognitive-behavior intervention with virtual reality and emphasizing neural mechanisms will decrease aggression in children. Child behavioral interventions centered on parents with coping empowerment have reduced symptoms of internalizing disorders such as ODD and conduct behavior. Also, the enhancing family behavior management program has significantly changed parental and children interaction. Generally, the studies have emphasized that behavioral protocols, cognitive-behavioral intervention, behavior management based on behavioral therapy, and parent-child interaction considerably reduce negative behavior and increase positive interaction in children with externalizing problems, including ODD.

Based on research findings, the combined use of behavioral interventions effectively treats children with externalizing disorders such as ODD. It has a significant effect in decreasing children's behavioral problems. The result of the research shows that family-focused behavior interventions have a substantial impact on improving behavior in children with the ODD.